Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACKIE LUCKETT
Active Sole ProprietorCommunity Health Worker · PORTLAND, OR
Registration Details
- NPI Number
- 1497925390
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Mar 6, 2008 (18.126826161143 yrs)
- Last Updated
- Mar 6, 2008
- License
-
172V00000X (OR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1500 NE IRVING STPORTLAND, OR, 972322243Browse OR providers · Browse ZIP 97232
- Phone
- 5032584222
- Primary Specialty
-
Community Health Worker
172V00000X
Other Community Health Worker Providers in PORTLAND, OR
| Name | Credential | NPI |
|---|---|---|
| LYNN MARIE BUKOWSKI | L.M.T. | 1689840456 |
| MR. MATTHEW GRAY | LMT | 1922243518 |
| CHRISTOPHER SCOTT GARY | PTA | 1932347168 |
| MS. FARLAND IDE JOHNSON | LMT | 1306072491 |
| WANDA PAULA FAYE GARFIAS | LMT | 1245566553 |
| MARGUERITE BERGIN | LMT | 1457677692 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.